A Reactive Hypoglycemia Diet May Be Your Answer to Ill Health

By: Dr. Michael Lam, MD, MPH; Dr. Justin Lam, ABAAHP, FMNM



Keep your symptoms at bay with a reactive hypoglycemia dietReactive hypoglycemia is sometimes referred to as postprandial hypoglycemia. These terms refer to a condition in which an individual who does not have diabetes experiences symptoms of hypoglycemia within a few hours of consuming a meal rich in carbohydrates. It is thought that the carbohydrates trigger a flood of insulin that continues beyond digestion and metabolism of glucose from the meal. The most effective treatment for this condition is to follow a reactive hypoglycemia diet, which involves eating several small meals consisting of high-fiber and starchy foods, limiting sugar, and regular exercise.

It is difficult to say how many people are affected by this condition, as there is not one standard defined diagnostic criteria. The US National Institutes of Health defines reactive hypoglycemia as hypoglycemic symptoms accompanied by blood glucose levels below 70 mg/dL, that are relieved by eating. Some doctors use the HbA1c test to measure blood sugar averages over the course of a couple of months, or a six hour glucose tolerance test. However, regardless of diagnosis, symptoms can be easily avoided by following a reactive hypoglycemia diet.

Symptoms of reactive hypoglycemia very depending on an individual’s hydration and sensitivity to the drop in blood sugar concentrations. Some symptoms include visual disturbances, difficulty concentrating, insomnia, cardiac arrhythmias, fatigue, dizziness, sweating, headaches, depression, anxiety, irritability, sugar cravings, increased appetite, nausea or vomiting, numbness in the hands and feet, and disorientation. In severe cases, coma can also result. If you notice any of these symptoms occurring within a few hours of eating a high carbohydrate meal, consider talking with a healthcare professional about a reactive hypoglycemia diet.

Hypoglycemia and the NeuroEndoMetabolic System

Hypoglycemia is a classic symptom of adrenal fatigue, and is defined as lower than normal blood sugar levels. However, it is difficult to determine a specific glucose value to define hypoglycemia as a number of different variables are involved. The normal blood sugar range is generally defined as 90 – 110 mg/dL, but there is some disagreement as to how low blood sugar needs to drop before diagnosis or treatment of hypoglycemia should be considered. Most people have glucose levels that fall into the hypoglycemic range occasionally without symptoms. This further complicates defining and diagnosing hypoglycemia. However, it does not take diagnosis to get relief with the reactive hypoglycemia diet.

Individuals with adrenal fatigue often have an even more difficult time with reactive hypoglycemia, as symptoms are typically subclinical, meaning there are hypoglycemic symptoms despite having blood glucose levels in the normal range, and normal fasting glucose tolerance test results.

Control your blood sugar with a reactive hypoglycemia dietCompared to an individual without adrenal fatigue, even one with insulin control problems, those with adrenal fatigue will be symptomatic for hypoglycemia despite normal blood sugar levels. After a meal, an individual with advanced adrenal fatigue may have more rapid dips in blood sugar below the hypoglycemic symptom threshold compared with a healthy individual. As adrenal fatigue becomes more advanced, dips in blood sugar and hypoglycemic symptoms occur more rapidly after eating. This is why it is so critical for individuals with advanced adrenal fatigue to eat a small snack every couple of hours. As the adrenal glands recover, the individual can go longer periods without eating, and not experience hypoglycemic symptoms. In fact, many individuals in very early stage adrenal fatigue, can skip a meal entirely with no symptoms at all, though this is obviously not a good idea, as skipping meals taxes the body’s reserves and increases adrenal fatigue. Even healthy individuals can benefit from following a diet similar to the reactive hypoglycemia diet, as it effectively keeps blood sugar levels stable throughout the day, providing lasting energy.

Everybody needs continuous energy to function throughout the day. The demand for energy, by the cells, is met by taking in food that can be converted into sugar. When the demand is not met, the body will burn stores of protein and fat to meet the need for energy. These energy sources are not as effective or efficient, but help meet some of the need. As the adrenal glands become fatigued, they slow down production of cortisol, which is needed in the conversion of various nutrients into glucose. Without adequate cortisol, the cells are not able to get the fuel they need for energy.

Acute hypoglycemia symptoms can be temporarily eased by taking 3 to 4 ounces fruit juice, though symptoms may return in a couple of hours. Every hypoglycemic episode can be more damaging to self, causing the body to hit a new low during every incident. If this occurs at the same time the cells call for glucose, conditions become right for adrenal crisis. Every dip advances adrenal fatigue a little bit more and causes hypoglycemia symptoms to worsen. Following a reactive hypoglycemia diet ensures that blood sugar levels stay well within the normal range, preventing hypoglycemia symptoms and cell damage.

The Reactive Hypoglycemia Diet

Hypoglycemia that occurs as a result of adrenal fatigue needs a comprehensive approach to reverse adrenal gland symptoms and prevent further damage.The reactive hypoglycemia diet is just as much about how you eat as it is about what you eat. There are two basic types of reactive hypoglycemia diets. The first focuses on reducing all types of carbohydrates and increasing protein and fats. The second focuses on reducing refined sugars and grains, increasing vegetables, fruits, and whole grains. Despite the differences, these reactive hypoglycemia diets have some important similarities. In particular, reducing all sugars, including natural sugars such as molasses and honey along with refined, highly processed carbohydrates such as most breads, cereals, potatoes, and rice. Your body doesn’t know or care whether the glucose it receives is natural or refined, sweet or not sweet. All it knows is what happens when glucose in the bloodstream rises and falls too quickly. While these foods are not considered to be high in sugar, they can be quickly converted into sugar in the body.

Eat frequently with a reactive hypoglycemia dietEat frequently – One of the biggest keys to the reactive hypoglycemia diet is ensuring the body constantly has the fuel it needs to do what it needs to do. Breakfast, lunch, and dinner are important, but snacks are equally as important. Have a mid-morning snack, a midafternoon snack, and a bedtime snack. Avoid drops in blood sugar by making sure you have good nutrition every 2 to 3 hours. If you still find yourself having symptoms you may need to eat smaller meals and snacks even more often. Listen to your body and eat when you feel like you need to eat, especially when engaged in demanding mental or physical activity. Keep easy snacks on hand so you always have something healthy to eat on the go.

Protein and fat – Be sure to include a bit of protein and healthy fat with every meal and snack. Protein and fat are slower to pass through the digestive tract causing sugar to be released into the bloodstream more slowly. More steady blood sugar decreases the insulin response, which means blood sugar will fall more slowly. Blood sugar dips more slowly there is less need for the adrenal glands to release adrenaline and cortisol to prevent blood sugar crashes. Good choices include nuts, meat, beans, and dairy foods for protein, and nuts, olive oil, coconut, yogurt, and avocado for fat.

Glycemic Index – Familiarize yourself with the glycemic index and avoid foods with an index of 60 or higher. This includes all refined sugars, candies, desserts, white bread, soda, fruit drinks, and more. These foods and beverages cause drastic spikes in blood glucose levels which are followed by significant drops. The glycemic index is a valuable tool for anyone following a reactive hypoglycemia diet. Some individuals can tolerate these foods if they are eaten as a small part of a well-balanced meal. Again, listen to your body and if you start noticing symptoms after eating a meal or snack including these foods, eliminate them from your diet. This is what makes the reactive hypoglycemia diet so widely effective; it can be specifically tailored to each individual, depending on the individual’s needs and reactions.

Fiber – Fiber as a part of the plant that cannot be digested. Insoluble fiber does not dissolve in water and soluble fiber does; both types of fiber slow digestion and absorption of glucose, preventing blood sugar spikes and crashes that cause hypoglycemia symptoms.

As part of a reactive hypoglycemia diet complex carbs can help keep you satisfiedComplex carbohydrates – Complex carbohydrates are a vital component in the reactive hypoglycemia diet. Complex carbohydrates are simply a chain of sugar molecules connected to one another. They take longer to break down than simple sugars, keeping blood glucose levels more consistent. At the same time, they can be used to provide energy to the cells more efficiently than proteins and fats. Good choices include oatmeal, fruit, barley, quinoa, and whole-grain pasta. It is important to remember, though, never to eat any type of carbohydrates alone. Always combine carbohydrates with some fat and protein to keep blood sugar levels consistent.

Caffeine and alcohol – Eliminating alcohol and caffeine will help increase the effectiveness of your reactive hypoglycemia diet. If you consume either of these in excess, you will want to wean yourself from them slowly, as stopping suddenly can cause very unpleasant withdrawal symptoms. If you do continue to consume caffeine or alcohol, be sure not to do so on an empty stomach.

Fruit – While fruits are high in many nutrients, they also tend to be high in sugar. Limit your fruit consumption and pay attention to any symptoms that occur after you eat it. If you notice symptoms of hypoglycemia after eating fruit, you may have to eliminate it, at least for a time.

Reactive Hypoglycemia Lifestyle

Following a reactive hypoglycemia diet is just one part of an overall lifestyle. Coping with hypoglycemia requires some extra effort on your part, but developing a few habits will make it easier. The following tips can be helpful to anyone who wishes to improve their health, whether they follow a reactive hypoglycemia diet or not:

Eat mindfully – Eating mindfully means taking time to chew your food, enjoying your food in a relaxed environment, and not eating until you are overstuffed. In Japan, many people follow a practice they call ‘Hara hachi bun me’, which loosely translates to eat until you are 80% full. It is likely no coincidence that Japan has obesity rates significantly lower than the United States, and much higher rate of centenarians.

Food journal – Keep a record of everything you eat for several days. Be sure to include everything you eat, everything you drink, and medications you take, along with the time. At the same time, keep track of all of your symptoms, and the time they occur. It may help to do this in two columns to make it easier to visualize connections. Within a few days, you may start to see a connection between what you eat and drink and your reactions to them. Armed with this information, you will soon know for certain what foods you can and cannot eat and you’ll know what to avoid.

Plan ahead – Having healthy foods on hand for meals and snacks is one of the most powerful things you can do to help yourself succeed on the reactive hypoglycemia diet. Take some time to plan your shopping trips, make a list, and stick to it. When you get home, take some time to repackage snack foods in small containers so they are easy to grab and you don’t have to think about what you’re going to eat.

Plan your meals out using a reactive hypoglycemia dietBreakfast – Be sure to eat breakfast as soon after waking as possible, as this will set the stage for a more successful day. Also, be sure not to skip meals or snacks, as frequent fueling will help keep blood sugar levels consistent.

Relax – Try not to freak out overall the foods you need to avoid. Rather, focus on the foods you CAN eat, and how much better they will make you feel. Also, don’t obsess over your reactive hypoglycemia diet. Obsessing over what you can and cannot eat will add to your stress and make the journey more difficult.

 
© Copyright 2016 Michael Lam, M.D. All Rights Reserved.


Keep your body energised with a reactive hypoglycemia diet




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4 Comments

  • Shasha says:

    Oregon grape root/Cr/Mg/alpha lipoic acid and more may help blood sugar along with fat/protein in a meal. When I got Lyme/coinfections my Mg/Mn/Fe went down as seen on a hair test. Mg helps make insulin. I got glycation after sugar from fruit hooked up with protein in my face. Eating protein did not make it worse, but helped and the supplements that lowered blood sugar and not eating fruit high in fructose. I had to raise my Mg dose…400mg of Mg citrate in the morning and 235mg later in the day. I took 600mg of alpha lipoic acid and 250 more later. Alpha lipoic acid helps bring sugar/food into the cells. I am still hooked on sugar with my adrenals burned out, but raising progesterone helps with blood sugar helps me not eat nonstop. Progesterone helps my immune system/adrenals and makes cortisol which helps my Lyme. Ozone treatments are awesome help for Lyme…can’t become resistant to it and it raises oxygen which kills microorganisms. Sugar/starch feeds Lyme bacteria.

  • Gloria Simonot says:

    Dr. Lam — I read ahead (followed links) to where you don’t recommend glandulars for older people but I find that they are the only thing that works for me. I have had several illnesses that seemed to damage my pituitary and also a severe hemorrhage during childbirth over 40 years ago — I have empty sella as confirmed by MRI (but not ordered by an endocrinologist so the pituitary was not measured that way. I am pretty sure that it is less than half the size and that my ACTH is not very high so my cortisol and adrenaline are always low (without the glandulars). I am 70 years old and do like to be able to do some things — I tell people that I don’t want to run any marathons, but would like to be able to vacuum a couple of floors without having to take a couple of days to “recover” from that short exercise.
    I am following a lot of the dietary advice and it is helpful but does not do the trick for me. So I am wondering if you would recommend glandulars in my situation since the problem seems to stem from poor pituitary hormones (not just the ones that stimulate other hormones).

    • Dr.Lam says:

      We have to be practical. If that is the “only” thing that works for you, you need to talk to your doctor. We usually do not find that to be the case, but becuase I dont know what else you have taken I cannot tell. Delivery system, dosage, frequencies etc are important factors to the effectiveness of any compound.

      Dr Lam